| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,096 |
2,030 |
$133K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
853 |
822 |
$65K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,799 |
1,775 |
$55K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,071 |
1,037 |
$43K |
| 92015 |
Determination of refractive state |
1,374 |
1,327 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
255 |
250 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
413 |
405 |
$13K |